Archives De Pediatrie最新文献

{"title":"Preliminary proposals for the follow-up of infants born to mothers with cystic fibrosis treated with CFTR modulators during the first two years of life.","authors":"Philippe Reix, Camille Audousset, Emmanuelle Girodon, Isabelle Sermet Gaudelus, Sophie Gautier","doi":"10.1016/j.arcped.2025.03.005","DOIUrl":"https://doi.org/10.1016/j.arcped.2025.03.005","url":null,"abstract":"<p><p>The number of pregnancies in women with cystic fibrosis (CF) has significantly increased in recent years, leading to a corresponding rise in the number of healthy infants exposed to cystic fibrosis transmembrane conductance regulator modulator (CFTRm) such as elexacaftor-tezacaftor-ivacaftor (ETI) or Kaftrio/Kalydeco® (K/K) triple therapy. Currently, data on the immediate outcomes for these children is reassuring; however, some cases of abnormal liver tests and cataracts have been reported in a few newborns indirectly exposed to ETI in utero or postnatally. Long-term neurodevelopment remains a concern that requires further investigation. A working group from the Société Française de la Mucoviscidose has developed recommendations for monitoring these children during the first two years and beyond. Given the increasing number of infants born to mothers taking CFTR modulators, as well as questions regarding their immediate care during the maternity stay and the feasibility of breastfeeding, it is crucial for pediatricians to be aware of these recommendations, which are based on a comprehensive review of the literature.</p>","PeriodicalId":55477,"journal":{"name":"Archives De Pediatrie","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2025-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144295438","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Residents' perceptions of the on-call experience and of the supervision of their clinical reasoning skills in the paediatric emergency department: A qualitative study.","authors":"Christine Pietrement, Racha Onaisi, Hubert Maisonneuve","doi":"10.1016/j.arcped.2025.03.003","DOIUrl":"https://doi.org/10.1016/j.arcped.2025.03.003","url":null,"abstract":"<p><strong>Background: </strong>A substantial number of residents suffer from stress, anxiety, which may be acutely exacerbated by stressful situations such as being on call. When confronted with complex situations, uncertainty, a lack of medical experience, residents experience a mismatch between their theoretical knowledge and their clinical reasoning skills. In a previous study we observed high levels of cognitive weariness and anxiety in residents being on call in the paediatric emergency department, and the reduction of their cognitive weariness by training clinician-educators in the supervision of clinical reasoning.</p><p><strong>Objectives: </strong>Thereafter we sought to inform the findings of our previous quantitative research by exploring in depth the experience of on-call residents in the paediatric emergency department, including: the factors that impact their well-being, and how supervision of their clinical reasoning might change it.</p><p><strong>Methods and setting: </strong>We performed a qualitative study using semi-structured interviews. We interviewed medical residents who were on call in the paediatric emergency department, mentored by paediatricians who had received specific training in the supervision of clinical reasoning.</p><p><strong>Results: </strong>The findings revealed two opposing profiles of how residents experience being on call and having their clinical reasoning supervised. First, there were those who expressed marked discomfort, characterized by anxiety, a strong need for supervision, a fear of being judged by the supervisor, and a major impact of physical fatigue. Residents with this profile seem to be at risk of developing burnout, or symptoms thereof. The second profile of residents expressed little unease, had a sense of self-efficacy, a feeling of personal competence, a high level of self-confidence, greater tolerance of uncertainty, and little difficulty with making decisions.</p><p><strong>Conclusions: </strong>Supervision of clinical reasoning based on questioning techniques seems to participate to promote development towards second profile, with greater tolerance of uncertainty, ease with decision-making, and a reinforced sense of belonging to a team.</p>","PeriodicalId":55477,"journal":{"name":"Archives De Pediatrie","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2025-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144295439","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Practical implementation of the collegial decision-making procedure in case of possible unreasonable obstinacy in Neonatology.","authors":"Charlotte Charbonnier, Anne Bellot, Grégoire Moutel, Mélanie Alexandre","doi":"10.1016/j.arcped.2025.03.002","DOIUrl":"https://doi.org/10.1016/j.arcped.2025.03.002","url":null,"abstract":"<p><strong>Introduction: </strong>The withholding or withdrawal of life-sustaining treatment has become the predominant cause of death in neonatal intensive care units. The advancements in perinatal medicine have led to a re-evaluation of the necessity and relevance of initiating and maintaining those treatments in patients whose conditions are not expected to improve. This decision must be made in accordance with the codified collegial decision-making process outlined in French law. In light of the shifts in end-of-life care, a review of professional practice is crucial.</p><p><strong>Objective: </strong>The objective of this study was to analyze the practical implementation of the collegial decision-making process in the Neonatology Department of the Caen University Hospital. The analysis focused on three key areas: the logistical setup, the compliance with the legal framework, and the deliberation mechanisms for each collegial decision-making process. To assess the implementation of the limitation of life-sustaining treatment meetings, a variety of methods were employed, including participant observation, review of medical records, and the distribution of surveys to participants.</p><p><strong>Results: </strong>In one year, 16 collegial decision-making processes were initiated, and 20 meetings were scheduled to discuss the restrictions on life-sustaining treatment. In 2 cases, the process was initiated by parents. The primary clinical condition that prompted the implementation of a collegial procedure was neurological. The presence of an external consultant was noted in 19 times. In 3 out of 20 times, parents weren't notified of their child's meeting prior to the date but all were informed of the meeting's conclusions. Data indicate a statistically significant correlation between professional category and perceived freedom to speak and legitimacy to do so, and the influence of the legal guardian's viewpoint on the participants' thinking.</p><p><strong>Conclusion: </strong>The legal framework was generally respected, and the culture of service facilitated the incorporation of the collegial procedure into the habits of professionals.</p>","PeriodicalId":55477,"journal":{"name":"Archives De Pediatrie","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2025-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144287168","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevalence of risk factors for developing childhood obesity in maternity.","authors":"Hélène Thibault, Marie Pailler, Caroline Carriere, Pascal Barat, Mélanie Le Goff, Nadira Ghemini, Loic Sentilhes, Muriel Rebola, Vincent Rigalleau, Thierry Lamireau","doi":"10.1016/j.arcped.2025.04.001","DOIUrl":"https://doi.org/10.1016/j.arcped.2025.04.001","url":null,"abstract":"<p><strong>Background: </strong>During the perinatal period several maternal and obstetric risk factors are known to be associated with overweight and childhood obesity.</p><p><strong>Method: </strong>The aim of this study was to determine the prevalence of risk factors for childhood obesity identifiable at birth. Data extracted from the computerized medical record (DXCARE^R) women who gave birth in the maternity ward of the University hospital of Bordeaux during a 11 months-period constituted an anonymized database to calculate the prevalence of the following risk factors: maternal obesity prior to pregnancy, excessive weight gain during pregnancy, maternal smoking, gestational diabetes, low socioeconomic status, cesarean delivery, macrosomia, and lack of breastfeeding. After eliminating duplicates and women for whom data on risk factors were missing, the population available for analysis was 1977 women who responded to inclusion criteria.</p><p><strong>Results: </strong>At the onset of pregnancy, mean age of women was 31.6 years [± 5.2] and mean BMI was 23.9 kg / m² [± 4.9], a third of them being overweight or obese. During pregnancy, half of women had excessive weight gain, gestational diabetes occurred in 15.9 % of them, 15.9 % smoked, and 18.1 % were in a precarious situation. Children were born by cesarean section in 15.3 % of cases. Depending on the definition used, exact birth weight (BW) or Audipog formula (percentile), neonates were large for gestational age in respectively 6.7 % of cases (BW> 4000 g) or 11 % (> 90th percentile) and small for gestational age in respectively 3 % of cases (BW <2500 g) and 6.8 % (<10th percentile). They were formula fed in 28.7 % of cases. The multivariate analysis showed that the association between excessive weight gain during pregnancy and birth weight is influenced by all other risk factors, except breastfeeding.</p><p><strong>Conclusion: </strong>Risk factors for developing childhood obesity, which are largely interrelated and influenced by medical care, can be identified as early as the maternity ward. Based on their prevalence, the development of a risk score will make it possible to set up an intervention program for the early prevention of childhood obesity right from the maternity ward.</p>","PeriodicalId":55477,"journal":{"name":"Archives De Pediatrie","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2025-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144287169","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reference values for liver stiffness in children using shear-wave elastography.","authors":"Célia Charlier, Saskia Vande Perre, Béatrice Dubern, Claire Apte-Dubuisson, Etienne Audureau, Margaux Bertrand, Hubert Ducou le Pointe, Eléonore Blondiaux","doi":"10.1016/j.arcped.2025.03.006","DOIUrl":"https://doi.org/10.1016/j.arcped.2025.03.006","url":null,"abstract":"<p><strong>Background: </strong>Ultrasound shear wave elastography (SWE) measures liver stiffness non-invasively in chronic liver diseases. Reference values in healthy children by age are needed in clinical practice.</p><p><strong>Objectives: </strong>Our study aimed to measure the reference values for liver elasticity by 2D SWE in a pediatric population stratified by age.</p><p><strong>Materials and methods: </strong>This retrospective study included 266 children without liver disease referred for an abdominal or renal ultrasonography from February 2022 to April 2022. Shear wave elasticity and shear wave speed were measured with a convex (6C1) or linear (SL15-4) transducer with a Canon Aplio 500 Aplio system performed for another reason in healthy children aged 0 to 19 years distributed in five age groups.</p><p><strong>Results: </strong>Median liver elasticity value was 5.50 kPa (interquartile range [IQR] 4.9-6.3) overall. Global analyses revealed values decreasing with increasing age from newborn to adolescence (elasticity: 6.0 kPa [IQR 5.4-6.5] to 5.3 kPa [IQR 4.7-6.4]; speed: 1.41 m/s [IQR 1.34-1.47] to 1.33 m/s [IQR 1.27-1.46], p < 10^-3). Elasticity values were lower with the convex than linear transducer (5.20 kPa [IQR 4.7-5.8] vs 6.2 kPa [IQR 5.6-6.6], p < 10^-4). Elasticity values increase with increasing age if we study each probe individually (from 1 year old to older). Median elasticity values were not associated with sex after adjustment for age or with BMI.</p><p><strong>Conclusion: </strong>Our study provides reference values for liver elasticity in healthy children by age and for two probes using an Aplio system. Liver elasticity values differed according to the probe used.</p>","PeriodicalId":55477,"journal":{"name":"Archives De Pediatrie","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2025-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144287170","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical features, treatment and outcomes of acute ethmoiditis: A case series of 20 hospitalized children.","authors":"Sarah Salameh, Noémie Lachaume, Alexandra Bisca, Manon Beauvais, Adrien Chaud, Marie Cotillon, Laure Cohen, Romain Basmaci","doi":"10.1016/j.arcped.2025.04.002","DOIUrl":"https://doi.org/10.1016/j.arcped.2025.04.002","url":null,"abstract":"<p><p>We described 20 children hospitalized with acute ethmoiditis between 2017 and 2022 in our center. Median age was 3.5 years, fifteen were Chandler's group II and three were group III. Despite adequate antibiotic therapy regarding national antibiotic treatment guidelines, six (30 %) patients experienced poor outcomes; five of them required surgical drainage, reinforcing the need of close surveillance of these children.</p>","PeriodicalId":55477,"journal":{"name":"Archives De Pediatrie","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2025-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144267948","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Description of the use of Vitamin D in children aged 0-18 months.","authors":"Margot Vrignaud, Stéphanie Provôt, Fabienne Aubin, Bénédicte Vrignaud, Josselin Bernard, Sonia Prot-Labarthe","doi":"10.1016/j.arcped.2025.01.006","DOIUrl":"https://doi.org/10.1016/j.arcped.2025.01.006","url":null,"abstract":"<p><p>Following the alerts issued by the French health authorities and the craze among parents wishing to use natural medicine, many cases of intoxication have occurred in recent years. We aimed to describe vitamin D intake by patients under 18 months of age in three hospitals in the Great West of France and via social networks. Data were collected on the caregivers (age, place of residence, vitamin D supplementation during mother's pregnancy, opinion on vitamin D), the patient (age, place in sibling group, diet), and the drug (prescriber, origin, form prescribed versus administered, dosage, medication or dietary supplement, number of omissions, reason for non-administration if any). Five hundred six responses were collected, highlighting a disparity in vitamin D administration in drug and dietary supplement form. Vitamin D was not administered in 7 % of the responses collected because there was no initial or renewed prescription). Food supplement was given to 77, i.e., 16 % of respondents. Only 43 % of mothers received supplementation during pregnancy. One person mentioned being very careful with the dosage as there had been a case of overdosing in their family. There were many different opinions expressed on the usefulness of supplementation: from \"no interest,\" \"gives colic,\" and \"questionable composition,\" to \"I am confused,\" and also \"essential\" or \"I have complete confidence in my doctor.\" Misinformation about vitamin D supplementation persists in the French population and leads us to consider how to educate the population about the role of vitamin D: handing out leaflets in maternity wards, increasing communication in magazines accessible to the general public, a media campaign, etc.</p>","PeriodicalId":55477,"journal":{"name":"Archives De Pediatrie","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2025-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144227740","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Severe urological involvement in junctional epidermolysis bullosa justifying bladder enlargement by sigmoidocystoplasty and Mitrofanoff appendicovesicostomy","authors":"Marielle Ehilé-Kacou ,&nbsp;Pierre Yves Mure ,&nbsp;Delphine Demede ,&nbsp;Alice Phan ,&nbsp;Justine Bacchetta ,&nbsp;Valeska Bidault ,&nbsp;Bruno Ranchin","doi":"10.1016/j.arcped.2025.01.002","DOIUrl":"10.1016/j.arcped.2025.01.002","url":null,"abstract":"<div><div>The urological complications of junctional epidermolysis bullosa (JEB) are difficult to manage because of the fragility of the skin and mucosa, and are not the subject of any recommendations. We report on 2 cases of chronic lower urinary tract dysfunction causing chronic kidney disease, treated by bladder enlargement with sigmoidocystoplasty and Mitrofanoff appendicovesicostomy after failure of medical treatment and suprapubic catheterisation several times a day. Follow-up was favourable in both children, with kidney function preservation and significant improvement of quality of life.</div></div>","PeriodicalId":55477,"journal":{"name":"Archives De Pediatrie","volume":"32 4","pages":"Pages 281-284"},"PeriodicalIF":1.3,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143665507","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Anxiety disorders and major depressive disorders in 299 adolescents hospitalized for assessment of common obesity: A retrospective cohort study","authors":"Morgan Seyler ,&nbsp;Caroline Barry ,&nbsp;Alexandra Loisel ,&nbsp;Marie Rose Moro ,&nbsp;Jonathan Lachal ,&nbsp;Hervé Lefèvre","doi":"10.1016/j.arcped.2025.01.004","DOIUrl":"10.1016/j.arcped.2025.01.004","url":null,"abstract":"<div><h3>Background</h3><div>Obesity has major psychosocial impacts in adolescents. Anxiety and depression are the most common psychiatric conditions in adolescents suffering from obesity.</div></div><div><h3>Objectives</h3><div>To measure and discuss the prevalence of psychiatric disorders in adolescents hospitalized for biopsychosocial assessment of common obesity during multidisciplinary care.</div></div><div><h3>Methods</h3><div>This retrospective monocentric study describes mental disorders over a decade (2012–2021) in 299 adolescents with obesity hospitalized for a global somatic and psychiatric assessment. Patients aged 11–18 were included. Sociodemographic data, psychiatric diagnosis, self-report questionnaires (CDI, <em>Children's Depression Inventory,</em> STAIC, <em>State-Trait Anxiety Inventory for children,</em> BES, <em>Binge Eating Scale</em>) were analyzed.</div></div><div><h3>Results</h3><div>27,4 % of adolescents had an anxiety disorder (AD), 18,7 % had a major depressive disorder (MDD) and 49,2 % had no mental disorder. In multiple regression models, exposure to physical violence (<em>p</em> &lt; 0.01), and the BES score (<em>p</em> &lt; 0.05) were also associated with a risk of AD. Exposure to physical violence, year of admission and the BES score were risk factors for MDD (<em>p</em> &lt; 0.05).</div></div><div><h3>Conclusions</h3><div>Prevalence of mental disorders is high and increasing, confirming the psychological suffering in adolescent with obesity. Some present with incomplete clinical profiles. MDD and AD are associated with a personal history of violence and a high BES score, reflecting in some adolescents a phenomenon of compensatory binge eating.</div></div>","PeriodicalId":55477,"journal":{"name":"Archives De Pediatrie","volume":"32 4","pages":"Pages 261-265"},"PeriodicalIF":1.3,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143674543","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Adverse events associated with intravenous immunoglobulin infusions in pediatric patients with primary immunodeficiency: A 10-year single-center study","authors":"Murat Özer,&nbsp;Seher Tekeli,&nbsp;Selçuk Doğan,&nbsp;Sema Çetin,&nbsp;Rıdvan Selen,&nbsp;Caner Aytekin","doi":"10.1016/j.arcped.2025.01.008","DOIUrl":"10.1016/j.arcped.2025.01.008","url":null,"abstract":"<div><h3>Background</h3><div>Intravenous immunoglobulin G (IVIg) is used as a replacement therapy in primary immunodeficiency disorders (PIDs). Although IVIg is generally accepted as a safe treatment, the incidence of adverse events (AEs), most of which are mild and transient, varies between 1 % and 81 %. The aim of this study was to determine the adverse effects and influencing factors associated with IVIg replacement therapy in pediatric patients with PID.</div></div><div><h3>Materials and Methods</h3><div>Children with PID who received IVIg replacement therapy between January 1, 2012 and December 31, 2021, at Dr. Sami Ulus Children's Hospital were included in our study.</div></div><div><h3>Results</h3><div>Overall, 69 (52 male, 17 female) patients who received a total of 2,025 IVIg infusions were evaluated. AEs were observed in 40.6 % of the patients and in 8.9 % of the infusions. All AEs encountered in the study were mild to moderate. Immediate-onset AEs were observed in 3.5 % of the infusions and delayed-onset AEs in 5.4 %. Late-onset AEs were not observed. The most commonly observed AEs were headache (<em>n</em> = 50, 2.5 %), fever (<em>n</em> = 37, 1.8 %), and malaise (<em>n</em> = 19, 0.9 %). The most common immediate AE was fever (<em>n</em> = 28, 1.4 %), while the most common delayed AE was headache (<em>n</em> = 44, 2.2 %).</div></div><div><h3>Conclusion</h3><div>AEs encountered in patients with PID receiving IVIg infusions are mild to moderate. Pediatric patients should be followed up for delayed AEs by contacting their families after the infusion is completed and should be questioned before the next infusion. IVIg replacement is a safe treatment when given with an appropriate premedication and infusion rate.</div></div>","PeriodicalId":55477,"journal":{"name":"Archives De Pediatrie","volume":"32 4","pages":"Pages 231-237"},"PeriodicalIF":1.3,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143813066","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}